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Disordered Eating
While only a small percentage of students meet the strict diagnostic criteria for an eating
disorder, many students struggle with food, weight, and/or body image concerns. These
concerns may result in restrictive dieting, emotional overeating, compulsive exercise, use
of various weight loss products or muscle building agents, cigarette smoking, or excessive
caffeine consumption. Not only can these disordered behaviors damage your physical
health, but they can also compromise your emotional well-being, your social life, and
your academic success.
Read on to learn how these behaviors harm our bodies, and what you can do to move
toward a healthier lifestyle if you struggle with these behaviors:
• Restrictive eating
• Emotional overeating or binge eating
• Positive steps towards change
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Restrictive Eating
To Eat or Not To Eat?
Robin is a tall, slender sorority woman with great grades, a great personality, and a great boyfriend. She
looks like she has the perfect body (and the perfect life!), but she’s always complaining about how fat
she is. She really “watches” what she eats—counting every calorie and fat gram, avoiding all sugars,
loading up on lots of vegetables—and now she’s talking about becoming a vegetarian for “health”
reasons. Once in a while, she’ll indulge in dessert at dinner. But whenever she does, she feels so guilty
and panics all night about how fat she’s going to get. She starts obsessing about how many calories she
just ate and how she’s going to make up for it tomorrow with an even stricter eating regimen or a more
rigorous work-out. Robin is suffering from restrictive eating, and it can lead to some serious problems
down the road.
Negative Effects of Restrictive Dieting and Starvation
There’s nothing wrong with watching what you eat and balancing your food choices to maintain a
healthy body. But, when taken to extremes--and the “watching” becomes obsessing several hours a day
and the “balancing” becomes rigid policing of every food—the behavior is no longer healthy. Think
about it, if you have to go to extremes to reach a certain weight or size, then your body was probably
not meant to be that weight or size in the first place!
Why do we need to eat?
The most basic reason is for energy. Energy in food is measured in calories. Each of us needs to eat
enough calories to meet our resting metabolic rate (the calories needed to maintain all of our body’s
internal functions at rest) AND our physical activity (the calories
needed to perform all the normal activities of daily living, as well as
purposeful exercise). Resting metabolic rate alone amounts to about
1100 calories per day in a petite 110 lb. woman and about 1700
calories per day in a lean 155 lb. man. Add to that, the calories
needed for moderate (not heavy) physical activity, and the total
calorie needs for that same woman and man amounts to about 1700
and 2700 calories per day, respectively, just for weight maintenance!
If you are taller, have more lean body mass, and/or engage in heavier
physical activity, you'll need even more calories to maintain your
weight.
Three things in food provide energy: carbohydrate, protein, and fat. Carbohydrate breaks down to
glucose to provide energy; and fat breaks down to fatty acids to supply energy. Protein breaks down to
amino acids, which can also supply energy if needed, but our bodies prefer to use them as building
blocks for all our vital cells, enzymes, and hormones. In addition to energy, we need to eat to get the
essential vitamins, minerals, fiber, and phytonutrients that food provides.
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What happens when we don’t eat enough calories?
Think of the calories in your body as the gas in your car to take a cross-country trip. The car needs a
certain amount of gas to get there. To make the trip, you would fill up the tank and refuel it several
times along the way. You wouldn’t just fill the tank half way, and you wouldn’t avoid refueling it when
the tank became empty. If you did, your car wouldn’t perform well, and you wouldn’t get to you
destination.
Our bodies need adequate fuel too, and our bodies need to be refueled every 3-5 hours to perform well.
If we don’t refuel our bodies with adequate calories throughout the day, our body (and all of its systems)
will start to shut down. Consider the negative consequences of inadequate calorie intake:
Physical effects
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Decreased resting metabolic rate. Your body slows down its internal workings so that it can survive
with fewer calories. This is why your weight may stay the same despite eating inadequate calories.
Loss of lean body mass. If your body isn’t getting adequate calories or protein from food, it will
break down your own body tissues (i.e. your muscles, organs, and even your heart!) for energy
and/or amino acids. As your lean body mass drops, your resting metabolic rate drops even more.
Changes in brain chemistry that increase appetite and food cravings. Serotonin levels decrease and
neuropeptide Y levels increase—both of these changes increase your appetite dramatically. This
may be why binge eating is so common after periods of restrictive eating.
In women, lowered estrogen levels and cessation of menses (amenorrhea). Over time, this can lead
to dramatic bone loss and osteoporosis, as well as infertility.
Constipation and gastrointestinal upset. Your digestive system (like all of your systems) slows down,
so food moves more sluggishly through you. Also, without adequate protein, you can’t produce the
digestive enzymes needed to break down food. This may be why it feels so uncomfortable when
eating normal amounts of food.
Sleep disturbance and weakness. Without adequate calories or carbohydrate, blood glucose levels
drop. This results in weakness as well as an increase in stress hormones that interfere with sleep.
Hypothermia (feeling cold all the time) due to inadequate body fat levels.
Decreased sexual interest. Without adequate calories or fat, your body can’t produce sex hormones
(estrogen and testosterone).
Cognitive effects
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Decreased concentration
Poor judgment
Apathy
Emotional and social effects
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Depression and anxiety
Irritability and anger
Lability (ever-changing mood)
Psychotic episodes
Personality changes
Social withdrawal
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NOTE: The cognitive and emotional side effects may be related to changes in the central nervous system
during starvation (when adequate carbohydrate, fat, and/or protein is not available). Each of these
nutrients is critical for optimal brain function. Carbohydrate is the only energy source that the brain can
use for fuel (other cells can use either carbohydrate, fat, or protein; but the brain can ONLY use
carbohydrate). Fat forms the major material of cell membranes in the brain and nerves (these
membranes are critical for normal transmission of chemical messages throughout the body). Protein
provides the building blocks for mood-regulating brain chemicals like serotonin (low serotonin levels
have been associated with depression and anxiety).
Effects on attitudes and behaviors towards food
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Food preoccupation. Your body desperately wants to eat, so all
of your thoughts and interests involve food.
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Collection of recipes, cookbooks, and menus. Again, your body
is fascinated with food because it is so hungry!
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Increased consumption of coffee, tea, and diet sodas. As your
energy levels plummet, you turn to stimulants in these beverages
to keep you going. What you really need is food energy (from
carbohydrate, fat, and protein).
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Loss of body’s natural mechanisms for regulating hunger and
fullness. When you let a diet dictate what and how much you
should or should not be eating, you lose touch with your internal cues that normally regulate hunger
and satiety. This can lead to overeating in the future because you can’t tell when your body is
physically full.
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Binge eating when food is finally available. After all, your body doesn’t trust that food will be
available again later. So, it desperately tries to hoard as much food NOW as it possibly can.
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Dichotomous thinking about food (i.e. “good food-bad food” mentality). Diet books love to put
foods in these two categories. And when they do, two things happen:
1) Your cravings for the so called “bad foods” increase (after all, whenever something is off limits
or forbidden, we seem to want it more).
2) Your risk of binge eating on the so called “bad foods” increases (after all, if you eat one cookie,
you’ve already blown your “diet,” so you might as well eat the whole box and then restart your
diet tomorrow).
As you can see from this list of effects, restrictive dieting not only negatively impacts your emotional,
social, and academic life, but it also can directly contribute to binge eating and weight re-gain (as mostly
fat) later. Consider this: there are more diet books, diet centers, diet supplements, diet drugs, and diet
foods now than ever before. And, there are more people dieting now than ever before. An estimated
one half of US women and more than 1/4 of US men are on a diet at any given time. Yet obesity rates
have increased 60% over the past two decades! And, eating disorders are more prevalent than ever!
Just a coincidence? No. Dieting helps contribute to both obesity and eating disorders.
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Overcoming Fears (if you are a restrictive eater):
If I eat more, won’t I gain weight?
Not necessarily. As you increase your calorie intake to a more
appropriate level, your resting metabolic rate will rev back up
to normal. So, even though you’re eating more, you will be
burning more, and your weight will stay the same.
NOTE: If you previously lost a large amount of weight rapidly
through very restrictive dieting and now you are underweight,
it may be in your best interest to gain a little weight back. But,
most of this weight gain will be due to the reconstruction of
your lean body mass. You can make an appointment with an
Ashe clinician for help with this.
How many extra calories does it take to gain 1 pound?
It costs about 3500 extra calories to gain 1 pound. In other words, if you need 2000 calories per day to
maintain your healthy weight, you would have to eat an extra 3500 calories per day (5500 calories total!)
to gain one pound a day. It’s very unlikely that you’ll eat that much or that you’ll gain that much weight
that fast.
NOTE: It’s important to realize that your weight may fluctuate 1 or 2 pounds each day depending on
when you weigh yourself. Whether or not you’ve just eaten, drank something, or gone to the bathroom
can cause your scale reading to fluctuate. But this does NOT mean that you have gained or lost 1-2
pounds of FAT each day. The weight change is simply due to
normal shifts in fluid levels and digestive tract contents. Don’t let
the scale numbers scare you.
To gain one pound a week (which is much more realistic), you
would have to continuously eat an extra 500 calories per day for
7 days. So, for a person whose maintenance needs are 2000
calories per day, that's 2500 calories per day for weight gain.
NOTE: If you have been eating a very restrictive diet for a while,
and you have lost a lot of weight, your metabolism may become revved up (above normal) when you
initially increase your calorie intake. Because of this, it may take many more extra calories before you
see a healthy gain in weight. As your weight gets closer to a healthy level, and as your body becomes
more accustomed to the more normal calorie intake, your metabolism will return to normal and you
won’t have to eat as many calories.
But, whenever I eat more, I can see my stomach getting fatter!
When you first start eating more, your stomach may appear more distended, but it is NOT fatter. Your
stomach may be distended because…
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There is more food in it (but it settles once the food has been digested).
You are retaining a little water (but that goes away after your body adjusts to the new eating
routine).
You are constipated (but as your digestive tract gets used to processing more food again, it will
speed up and your bowel movements will normalize).
Positive Steps For Change
1. Discover what purpose restrictive eating and dieting is
serving in your life. Is it your way of asserting control?
Dealing with an underlying anxiety disorder? Boosting a
damaged self-esteem? There are many reasons why
people develop disordered eating behaviors. Take
advantage of the caring and confidential counseling
services on campus to help you make this self-discovery.
2. De-code your “fat feelings.” When you say you are
feeling fat, is there a feeling underneath? Are you
feeling insecure, sad, overwhelmed…? Learn how to
express your emotions without abusing food or your
body. Use the Eating Awareness Journal to help you.
3. Determine what weight is a healthy weight for YOU. Each one of us has a healthy weight based on
our genetics, muscle mass, and body type. Being under your healthy weight is just as damaging to your
health as being above your healthy weight. Sometimes it’s hard to accept the weight that is healthy for
you (especially with the media’s ideal body in mind). But, learning to love your body is key to treating it
with the respect and care it deserves.
4. Learn the basics of good nutrition so you can fuel your body with optimal energy and nutrients.
After months (or years) of restrictive dieting, you may not know what normal eating looks and feels like.
And, you may be scared to adjust your eating plan on your own. Seek the guidance and support of a
Registered Dietitian to help you.
5. Take baby steps towards your goals, and be patient with your progress. If you have learned that
your body needs about 1800 calories per day (but you are only eating 1000), start by trying to add 200
calories to your usual plan. Start by adding more foods you are comfortable eating, and then gradually
challenge yourself by adding some of the “forbidden” foods you have previously avoided. No food
needs to be strictly forbidden. Balance and moderation are key to health and happiness.
6. Listen to your self-talk. That “little voice” in your head is your self-talk. Positive (or negative) selftalk can be very powerful. If you go into an exam, thinking “I can do this. I’m totally prepared. I’m going
to ace this thing!” you’re far more likely to be successful than if you go in, worrying “I’m not ready for
this. I’m going to fail!” In addition to affecting your academic performance, self-talk influences your
athletic performance, your ability to overcome personal crises, and your eating behaviors.
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